HealthDay News — Household income is tied to significant differences in hospitalizations for ambulatory-care-sensitive respiratory conditions, according to research published in the Annals of Family Medicine.

“There is a well-established link between ambulatory-care-sensitive conditions and socioeconomic status; individuals living in low-income areas are hospitalized for these conditions more often than their high-income counterparts,” explained Aaron J. Trachtenberg, DPhil, from the University of Manitoba in Canada, and colleagues.

To identify a disparity between patient income and ambulatory-care-sensitive conditions in patients aged 18 to 70 years with obstructive airway disease (chronic obstructive pulmonary disease or asthma), the investigators analyzed administrative data from the city of Winnipeg. Patients were categorized into census-derived income quintiles based on average household income.

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Of the 34,741 patients identified with obstructive airway diseases, 2.1% (n=729) were hospitalized with a related diagnosis during a two-year period, reported the inspectors. Hospitalization was more likely among patients with a lower income compared with patients with the highest income.

The effect of socioeconomic status remained virtually unchanged after the researchers controlled for every other variable, said the scientists. Patients in the lowest-income quintile had approximately three times the odds of hospitalization compared with those in the highest-income quintile (odds ratio, 2.93) in a fully adjusted model.

“Our findings suggest that we look beyond the health care system at the broader social determinants of health to reduce the number of avoidable hospitalizations among the poor,” concluded the researchers.


  1. Trachtenberg A et al. Annals of Family Medicine. 2014; doi: 10.1370/afm.1683